Coronary sinus sucker



Feb. 16, 1965 F. s. KNOX m, ETAL 3,169,528

CORONARY SINUS sucxma Filed May 24, 1955 INVENTOR FRANCIS S. KNOX II 9HARLESTON J. HAL LAR ATTORNEY such as a suitable transparent plasticmaterial.

United States Patent 3,169,528 CORONARY SlNUS SUCKER Francis S. Knox El,814 Woodsdale Road, Wilmington, Del, and Harleston J. Hall, Jr., 261Upper Mountain Ave, Upper Montclair, NJ.

Filed May 24, 1963, Ser. No. 282,895 2 Claims. (Cl. 128-359) Thisinvention relates to a surgical drainage collection device.

The primary object of this invention is to provide a surgical drainagecollection device or coronary sinus sucker which is adapted to be usedfor reclaiming reusable blood from the operative field during open heartsurgery and the like.

A further object is to provide an aspirator or coronary sinus suckerwhich consists of one or more tubes that are adapted to be made of asuitable material such as transparent plastic material which may bepolvinyl chloride, and wherein the reinforcing member such as a lengthof wire is suitably embedded in the tube or tubes, and wherein the endsof the wire terminate inwardly at the ends of the device.

Still another object is to provide an improved coronary sinus sucker forcardiac surgery and the like wherein there is provided a reinforcementwhich causes the sucker to retain any configuration into which it isbent, and wherein the present invention can be made at low cost, andwherein in one form of the invention the wire may be embedded in thewall of a single tube, or else in another form of the invention thelength of wire may be interposed between inner and outer concentricallyarranged tubes.

Another object is to provide a surgical drainage collection device ofthe character described that is economical to manufacture and efficientin use, and further objects and advantages are to provide improvedelements and arrangements thereof in a device of the character describedthat is durable in form and conducive to the most economical use ofmaterials and uniformity of members formed therefrom.

Still further objects and advantages will become apparent in thesubsequent description in the specification.

In the drawings:

FIG. 1 is a perspective view illustrating one form of the surgicaldrainage collection device of the present invention.

FIG. 2 is an enlarged sectional view taken on the line 2-2 of FIG. 1.

FIG. 3 is a sectional View taken on the line 3-3 of FIG. 1.

FIG. 4 is a sectional View taken on the line 4-4 of FIG. 1.

FIG. 5 is an enlarged fragmentary sectional view taken on the line 55 ofFIG. 4 illustrating certain constructional details of the presentinvention.

FIG. 6 is a view similar to FIG. 1 illustrating a modification.

FIG. 7 is a sectional view taken on the line 77 of FIG. 6.

FIG. 8 is a sectional view taken on the line 88 of FIG. 7.

FIG. 9 is a fragmentary sectional view illustrating a furthermodification.

Referring in detail to the drawings, and more particularly to FIGS. 1through 5 of the drawings, the numeral 23 indicates the surgicaldrainage collection device of the present invention which is shown tocomprise a pair of concentrically arranged inner and outer tubes 21 and22 which are adapted to be made of a suitable material The numeral 23indicates a length of wire or ductile material or metal which isinterposed between the tubes 21 and 22, and as shown in the drawings theinner tube 21 is longer than the outer tube 22 so that there is defineda projecting end portion 24 for connecting to the intake hose of asuction system of conventional construction, and the opposite endportion 25 of the tube 21 defines a pickup end. As shown in FIG. 1 forexample, the end portion 25 has a plurality of spaced apart perforationsor apertures or openings 26 therein, and other apertures or openings 27are also arranged in the end portion 25 in spaced relation from theapertures 26. As shown in FIG. 5, with the wire 23 interposed orembedded between the tubes 21 and 22, the adjacent portion of the tube.22 has a tendency to bulge outwardly as at 28, and the adjacent orcontiguous portion of the tube 21 has a tendency to bulge inwardly as at29. The ends of the tube 21 are open as at 30 and 31, and the numeral 32indicates the hollow interior of the inner tube 21.

The tubes 21 and 22 are adapted to be bonded together at their meetingsurfaces and at the ends of the larger or outer tube 22.

Referring now to FIGS. 6, 7 and 8 of the drawings, there is illustrateda modified or alternative surgical drainage collection device which isindicated generally by the numeral 33, and the device 33 is in the formof a single tube sucker wherein the single tube is indicated by thenumeral 37, and the ends of the tube 37 are open as at 34 and 35. Thenumeral 36 indicates a length of wire which is embedded in the wall 45of the single tube 37, and the tube 37 is longer than the wire 36 sothat there is defined a projecting end portion 44 which serves the samepurpose as the previously described projecting end portion 24 of thedevice 20. Also there is defined at the other end of the tube 37 apickup end 38 which has spaced apart openings 32 and 49 therein. Asshown in FIG. 7, with the wire 36 embedded in the wall 45 of the tube37, portions of the wall contiguous to the wire bulge outwardly andinwardly as at 41 and 42. The numeral 43 indicates the hollow interioror bore of the tube 37.

From the foregoing, it will be seen that there has been provided animproved surgical drainage collection device or coronary sinus sucker,and in use with the parts arranged as shown in FIGS. 1 through 5 forexample, it will be seen that the device 20 consists of the inner andouter tubes 21 and 22 with the wire 23 interposed between the tubes 21and 22. The tube 21 is longer than the tube 22 so that there is defineda projecting end portion 24 as well as the pickup end portion 25, andthe end 25 has the openings 26 and 27 therein. The tube 22 is longerthan the wire 23. The tubes are adapted to be made of a suitablematerial such as suitable transparent plastic material.

In the form of the invention shown in FIGS. 6, 7 and 8, the device isindicated generally by the numeral 33 and consists of a single tube 37which has the wire like member 36 embedded in the wall 45 thereof, asfor example as shown in FIG. 8. The tube 37 is adapted to be made oftransparent plastic material, and the tube 37 is longer than the wire 36so that there is defined a projecting end portion 44 and the oppositelyarranged pickup end portion 38, and the pickup end portion 38 has theopenings 39 and 40 therein which serve the same purpose as thepreviously described openings 26 and 27.

It will be seen that in FIGS. 1 through 5 that there has been provided asurgical drainage collection device which consists of two concentrictubes made of transparent thermoplastic material and polyvinyl chlorideis especially suitable as a material for making the tubes. These tubesenclose between their walls the length of ductile metal such as thecopper wire 23, and as shown in FIG. 1, the larger tube extends beyondboth ends of the wire 23,

and the smaller tube 21 extends beyond the end of the larger tube 22.The smaller tube 21 has the apertures or perforations 25 and 27 in oneend thereof for facilitating the collection and aspiration of fluids.These two tubes 21 and 22 are bonded together by any suitable meanswhere their surfaces meet or join at each side of the wire and aroundthe ends of the larger tube, and the present invention provides certainimportant advantages or improvements over existing devices and thepresent invention is especially suitable for use during surgery,especially where drainage is to be returned to the circulatory system ofthe patient.

As shown in FIGS, 6, 7 and 8 the surgical drainage collection device 33may consist of a single tube 37 which has the length of ductile metalsuch as copper wire 36 embedded in its wall 45, and the tube 37 extendsbeyond the ends of the wire.

In both forms of the invention the device is bendable along its axisthroughout the greater portion of its length at the will of the user,and the device will retain its bends or curves until again adjusted oraltered by the user, and the device will contribute greatly or helpmaintain a clear view of the operating field and also will maintainclear working space for the surgeons hands as well as for the surgicalinstruments.

Due to the bendable nature of the device, it is suitable also for use asa surgical retractor while also performing its primary function. Thedevice is adapted to utilize materials, because of its construction,which do not require surface treatment or coating for inhibiting damageto the blood of the patient. In addition, because of the material whichcan be used in its construction, and because of the bendablecharacteristic of the device, and due to its uniform diameter, it can beused as a postoperative drain inserted through a small orifice oropening in the body. The device can be made at low cost as compared toexisting such devices. In addition because of its construction, thepresent invention will permit and insure a significant reduction in costof its preparation for reuse since no special surface treatment isrequired and due to the consequent reduction in time required forpreparing the device for reuse. The openings such as the openings 26 and27 or the openings 39 and 49 are arranged in one end of the device so asto insure that that one end is made more flexible and this flexibilityhelps reduce the danger of trauma to the blood vessels or other livingtissue to which the tube may be applied.

The aspirator or coronary sinus sucker of the present invention isintended primarily for reclamation of reusable blood from the operativefield during open heart surgery, and it is also useful for removingdiscardable fluids during other types of surgery, and it can also beused as a drainage catheter. That is, it can be left in the incision fora part of the post-operative period to permit drainage of waste productsand the like. The device is adapted to be made of a suitable materialsuch as a suitable plastic tubing such as polyvinyl chloride, and thewire member may be annealed copper or brass Wire, and and vinyl cementis adapted to be used for bonding or joining the parts together. Theparts can be made in different shapes or sizes and of various materialsas desired or required. The suckers may have an inner bore for examplethat ranges from /8 inch to A inch, and the tubing may be made indifferent lengths, and for example the tubing 21 may be 30 centimeterslong. The larger diameter tubing 22 may be about 18 to 20 centimeterslong, and the piece of wire 23 is inserted or interposed between theinner and outer tubes, and this wire may be several centimeters shorterthan the outer tube and may have a diameter of about .085 to .09 inch.Vinyl cement is adapted to be introduced or used between the tubes forbonding the tubes together along either side of the length of Wire andfor bonding the ends of the outer tube to the surface of the inner tube,and this cement serves to fix the Wire in an alignment roughly parallelto dthe longitudinal axis of the tubes, and also serves to seal off thewire so that no blood or other liquids can come into contact with thesame.

The projecting end 24 of the inner tube 21 is adapted to be fitted tothe intake hose of a conventional suction system, and the other end istrimmed so that approximately 1.5 to 3.5 centimeters project beyond theend of the outer tube 22. As shown in FIG. 1 three or four openings orperforations 26 which may be .1 to .2 centimeter in diameter at theinner surface are made in the wall of the inner tube close to its openend 31, and two or three similar holes 27 are formed in the tube wallnear the end of the outer tube 22. Due to this construction, with thedevice being used, when the open end 31 is placed against tissue or thelike, fluid will be drawn through the openings 26 near the tip, and ifthese openings should become occluded by solid matter, the openings 27further from the tip will admit air to reduce the suction and to permitthe tip to be moved without pulling or causing damage to the tissue.

An important feature or aspect of the present invention is that it ispliable or malleable and it can be bent easily so that it can passaround obstructions and can be kept out of the surgeons way. Theinelastic wire 23 or 36 prevents the plastic from springing out of thedesired shape or configuration, and there is enough inherent stiffnessto permit the sucker to double as a retractor in certain applications.In cardiac surgery the drainage is put back into the patients bloodsupply through the heart-lung machine, and the suckers that are nowgenerally in use are made of stainless steel which promotes excessivefoaming when in contact with a mixture of blood and air and they musttherefore undergo inconvenient processing before each use thereof. Vinylplastics do not promote foaming and no prior treatment of the surface isrequired, and relative low cost permits them to be discarded after beingused if it is desired to avoid cleaning, rinsing, wrapping, sterilizingand the like. Another important feature of the present invention is thetransparency of the tubing and the fact that the device collapses due tosuction if all of the intake openings become occluded. Thus the surgeonscan readily take notice of any change in conditions without beingrequired to turn their heads or to request information or the like.

In the modification of FIGS. 6, '7 and 8 the device consists of a singletube sucker with the st ffening wire 36 embedded in the wall 45 of thetube.

Coronary sinus suckers heretofore available have had a number ofdisadvantages or drawbacks such as being expensive, somewhat difficultto clean, and usually they have been made of stainless steel and must becoated internally with silicone grease before each use for inhibitingfoaming of blood, and in addition they are rigid and thus cannot beshaped to conform to cavities, apertures and the like. In order toovercome these disadvantages, the sucker of the present invention hasbeen made pliable and is made of a material other than steel, and vinyltubing is especially suitable for making the parts, and when making thedevice of two pieces of tubing of different diameters, the diameters aresuch that there is a fairly close fit one within the other. The device20 in FIGS. 1 through 5 is assembled or formed with the straight pieceof annealed copper or brass wire that is 1 or 2 centimeters shorter thanthe outer tube inserted between the walls of the two tubes, and vinylcement is arranged along both sides of the wire and around both ends ofthe outer tube, and this serves to insure that the wire is maintainedisolated and is also held loosely but adequately in alignment along theaxis of the tubing.

enerally when the sucker is used, the conditions are such that smallquantities of blood from shallow pockets are intermittently collected.It is not feasible to use a single intake orifice because any tissueencountered will be drawn against the orifice and close it and defeatits purpose and thus make withdrawal difficult and may result in atraumatic condition. Thus metal sucker tips are of necessity usuallyrather complicated in order to pernut ventilation thereof. Unfortunatelythis means that turbulent mixing of air and blood occurs inside the tipexcept at the rare moments when the entire tip is submerged and thiscondition is known to pfomote foammg and is believed to be an importantfactor contributing to hemolysis. Since there seems at the present timeno Way of overcoming these conditions, the present invention has beenprovided in such a manner as to maintain the instrument as simple aspossible and to provide ventilation merely by perforating the wall atthe pickup end 25 or 38 of the protruding tube portion, and this isentirely satisfactory insofar as blood pickup and ventilation areconcerned even when the total area of the openings or apertures is muchgreater than the cross-sectional area of the tube lumen.

In addition the plastic suckers are much less noisy than the metaldevices and they can be autoclaved but because of the heating having atendency to cause some softening, preferably gas sterilization is used.Since the parts are made of plastic, the plastic will not cause foamingor clotting and no silicone grease coating is required. Also, hemolysiscaused by contact with the tube wall will be minimized or reduced ascompared with metal tubes. Furthermore since there is no abrupt changeof section within the tube, there is little tendency to turbulence andconsequential ill effects. The primary advantage of the presentinvention is that the wire reinforcement causes the sucker to retain anyconfiguration to which it is bent. This means that the surgeon canmanipulate the device with one hand if necessary, into any combinationof curves and bends to suit the particular requirements, and the suckercan serve the additional function of a retractor if desired or required.Also the sucker can be used as a coronary perfusion instrument duringlengthy open heart surgery with the advantage over existing devices thatit can be shaped in situ in order to conform to the individualpeculiarities of the cardiac region of a particular patient.

The materials are inexpensive and the devices can thus be made at a lowcost. While the suckers may not need to be reused in view of the lowcost thereof, if necessary they may be reused in subsequent operationsat least until the wire begins to work harden or difiicult to managekinks form.

In the device of FIGS. 6, 7 and 8 the wire 36 is embedded in the wall ofthe single tube and both forms of the invention are inexpensive to makeand eflicient in use.

As shown in FIG. 5 the two tubes are brought together just past the endof the wire 23 so there is practically no void remaining. Similarly inFIG. 8 there is substantially no void remaining at the end of the wire36 and the device can be made in any suitable manner as for example byvacuum forming during extrusion so that there will be a fairly tightclosure. As shown in FIGS. 6, 7 and 8 for example, the wire 36 isarranged relative to the center line of the tube 37 so that the tubewall bulges outwardly as well as inwardly as at 41 and 42 and this helpsprevent occlusion at sharp bends. The outwardly and inwardly bulgingportions 28 and 29 serve generally the same purpose as the bulgingportions 41 and 42.

Attention is directed to FIG, 9 of the drawings wherein the numeral 47indicates a further modified portion of a coronary sinus sucker thatincludes a tube 48 of suitable material such as transparent pliablematerial, and a length of wire 49 is arranged in the tube 48, and thetube 48 is longer than the wire 49 so that there is defined a pickup endportion 53 that has its tip or end closed as at 59. The portion 53 isadapted to be provided with apertures 51 therein as well as largeropenings or holes 52 therein.

Thus, instead of having the end open as at 31 or 35 in connection withthe previously described arrangements, the end or tip is closed as at50, and the openings such as the openings 51 and 52 suffice for theintended or desired purpose so that it is not necessary to have the endopen as at 31 or 35.

Also, the sucker of the present invention may be used in a smallerdiameter and with a longer perforated tip as a specialized abdominaldrain, and one of the medical procedures would be to use such a drain asa catheter for peritoneal dialysis. It may be used also for theintroduction of fluids for flushing out body cavities or surgical fieldssuch as a feminine douche.

Minor changes in shape, size and rearrangement of details coming withinthe field of invention claimed may be resorted to in actual practice, ifdesired.

What is claimed is:

1. An appliance for thoracic, cardiac surgery, said appliance adapted tohave body fluids pass therethrough, said appliance embodying a tubehaving a bore, a proximal end and a distal end, said tube having atleast one of its ends open, said tube having a cylindrical shaped wall,said tube being made of pliable transparent plastic material, and areinforcing member consisting of a wire that is arranged externally ofthe bore of said tube, said reinforcing member being made of ductilematerial and being affixed to said tube, and said reinforcing memberbeing shorter than said tube wherein the reinforcing member has its endsterminating inwardly of the ends of the tube, so that the proximal anddistal ends of the tube are not reinforced thereby alleviating damage tothe body tissue, said reinforcing member adapted to initially supportsaid tube in a first configuration whereupon upon bending said tube intoa second configuration, said member will retain the tube in theconfiguration into which it is shaped and bent, said distal end alwaysretaining a straight shape, said wire being circular in cross sectionand permitting all portions of the appliance to bend in any direction.

2. The structure as defined in claim 1 and further including aperturesin one of the end portions of the tube, and the other end portion of thetube being free of apertures, said wire terminating at a point spacedinwardly from said apertures.

References Cited by the Examiner UNITED STATES PATENTS RICHARD A,GAUDET, Primary Examiner,

1. AN APPLIANCE FOR THORACIC, CARDIAC SURGERY, SAID APPLIANCE ADAPTED TOHAVE BODY FLUIDS PASS THERETHROUGH, SAID APPLIANCE EMBODYING A TUBEHAVING A BORE, A PROXIMAL END AND A DISTAL END, SAID TUBE HAVING ATLEAST ONE OF ITS ENDS OPEN, SAID TUBE HAVING A CYLINDRICAL SHAPED WALL,SAID TUBE BEING MADE OF PLIABLE TRANSPARENT PLASTIC MATERIAL, AND AREINFORCING MEMBER CONSISTING OF A WIRE THAT IS ARRANGED EXTERNALLY OFTHE BORE OF SAID TUBE, SAID REINFORCING MEMBER BEING MADE OF DUCTILEMATERIAL AND BEING AFFIXED TO SAID TUBE, AND SAID REINFORCING MEMBERBEING SHORTER THAN SAID TUBE WHEREIN THE REINFORCINT MEMBER HAS ITS ENDSTERMINATING INWARDLY OF THE ENDS OF THE TUBE, SO THAT THE PROXIMAL ANDDISTAL ENDS OF THE TUBE ARE NOT REINFORCED THEREBY ALLEVIATING DAMAGE TOTHE BODY TISSUE, SAID REINFORCING MEMBER ADAPTED TO INITIALLY SUPPORTSAID TUBE IN A FIRST CONFIGURATION WHEREUPON UPON BENDING SAID TUBE INTOA SECOND CONFIGURATION, SAID MEMBER WILL RETAIN THE TUBE IN THECONFIGURATION INTO WHICH IT IS SHAPED AND BENT, SAID DISTAL END ALWAYSRETAINING A STRAIGHT SHAPE, SAID WIRE BEING CIRCULAR IN CROSS SECTIONAND PERMITTING ALL PORTIONS OF THE APPLIANCE TO BEND IN ANY DIRECTIONS.